The incidence and mortality rates of pancreatic cancer (PC) are rising rapidly, and PC became the fourth leading cause of cancer-related death in the USA and Japan. For early detection of PC, Japanese clinical practice guidelines recommend CT, MRI and EUS, if patients have either of clinical manifestations, elevation of serum pancreatic enzymes or tumor markers, risk factors and US findings suggestive of PC. Several studies have demonstrated that social network program between primary care offices and referral centers, measuring PC biomarkers in blood, saliva and duodenal juice, periodic follow-up of IPMN or indirect imaging findings of the pancreas, and surveillance for familial PC and inherited PC syndrome are beneficial for early detection of PC. In this international panel discussion, we discuss the current status and future perspective of the researches and clinical practices for improvements of early detection and prognosis of PC.